Day In, Day Out with Alzheimer′s

• Preface Acknowledgments 1. An Introduction to Dementia and Caregiving The World of Dementia Care * Care as Control * The Medicalization of Senility: A Historical Shift * The Biomedical Model of Dementia * A Socioenvironmental Model of Dementia Care * Conclusion 2. Losing It: Stress and Distress in Alzheimer's Day Care Energy: Demanding Work * Losing People: Losing Control * We/They: Social Support * The Caregiving Relationship * The Price of Stress: Quality of Care * Conclusion 3. Care and Control: Managing Stress by Medicalizing Deviance Assessing "Level of Severity" * Infantilization: The Medical Model of Care * Social Control * Social Distance * Staff Stress and Quality of Care in a Nonmedical Program * Conclusion 4. Medicalization, Stress, and Care: Contrasts between Two Day Care Centers Medial and Nonmedical Programs: Structural Conditions * The Medical Model of Caregiving * Contrasts in Work-Related Stress * Contrasts in Quality of Care * Conclusion 5. The Physical World of Day Care: Environmental Stress and Control Environmental Stress: Four Facility Design Features * Environmental Control and Medicalizing Deviance * Facility Design and Staff Stress: A Case Study * Conclusion 6. What Worked: Providing Quality Care with Minimal Staff Stress A Model Program at Valley Day Care Center * Conclusion 7. What's Next: Research, Practice, and Policy Implications Research Implications * Practice Implications * Policy Implications * Conclusion Appendix A: Research Methods and Researcher Role Appendix B: Tables Notes References Index

"...an insightful and constructive view of persons with dementia and their caregivers." --Carroll L. Estes, Institute for Health & Aging, University of California, San Francisco "[A]n insightful, comprehensive analysis of the unique reciprocal relationship between people with Alzheimer's disease and people who care for them. The author's compassionate concern emphasizes the need for innovative methods of care which alleviate stress for the care-giver and distress for the patients...an important book for policy makers, health care administrators, medical and nursing students, and all others who care." --Maggie Kuhn, Founder and National Convener of the Gray Panthers